By Kim Pollard
My first assignment with Doctors Without Borders/ Médecins Sans Frontières (MSF) was in the city of Lashkar Gah, the capital of Helmand province in the southern part of Afghanistan. My job was to supervise the neonatal and pediatric intensive care unit in MSF’s 309-bed Boost hospital.
When I arrived in Helmand, things were relatively quiet and stable. The security changed a few short weeks after my arrival, however. At the beginning of August 2016, shelling and shooting started in the city. We could hear it all around us. Before long, the Taliban had completely surrounded the city and were about 500 meters away from the hospital and our compound. International forces arrived and we were soon in the middle of a conflict zone. Jet bombers and drones could be heard flying overhead at high speed.
All roads out of Lashkar Gah were controlled by armed forces. Many civilians were injured or killed during the conflict. When the fighting intensified in October, people panicked and many patients, caregivers and even staff left the hospital to flee the city.
The impact of the fighting could be most clearly seen in the lack of civilian admissions to the hospital. The malnutrition, neonatal and pediatric intensive care units that are often filled at 200 per cent above capacity during peaceful times suddenly had countless empty beds. While many people had fled Lashkar Gah in fear, others were unable to get to the hospital from surrounding districts because of insecurity and road blocks. Those that did manage to come to the hospital often arrived too late.
I was amazed that with all the fighting around us, the children were still outside playing, and that people still went to work. I got used to the constant sound of bombs, drones and helicopters, and just carried on doing what I was doing. I adjusted to the environment.
I remember that when the fighting in the area was escalating to a feverish pitch, we had a patient who had given birth to a premature baby in the hospital. The baby weighed around one kilogram, was in an incubator and was receiving IV antibiotics, tube feeds and oxygen therapy. The mother expressed a desire to leave the hospital with her baby. She explained that there was nobody at home to care for her other children and that the fighting was reported to be very close to her home. Her husband insisted that she should leave. After two days of negotiations with her and her husband, she left with the baby. She said that she understood that the baby would likely die if she left the hospital, but that her family desperately needed her at home. I witnessed this sort of impossible choice repeatedly during my time there.
It might seem surprising, but despite the rather scary situation, I had the most wonderful time in Afghanistan. I always felt welcome and included. Local people were happy to share their culture with me and learn about mine. My national staff partner Rohulla invited me to his home, where I spent a wonderful day. He introduced me to his family, we sat and drank tea and ate an amazing meal. This was truly a highlight of my time there.
One day, I spent an hour in our high dependency pediatric unit with three mothers, a grandmother and an orphaned little girl. The lives of all the children were still very much at risk of being lost, but even this did not stop the mothers and grandmother from participating in the universal language of women. Lots of smiles, hugs and laughter filled the room as I sat and visited with them. We talked about the trouble with men and the joy of motherhood.
Afghanistan is an amazing place filled with wonderful people whose lives are overshadowed by war. I will miss the country and the people I have come to call friends.
My seven months in Afghanistan have been the most intense, exciting, rewarding experience of my life.
Kim Pollard is a nurse from Calgary.